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The primary purpose of this per diem position is to perform both on and off site providing support to the Payment Integrity office and per-diem nurse staff. The Auditor will complete audits following department guidelines and client established parameters. The Auditor must be motivated, a self-starter and able to work independently. Must actively participate with other staff as part of an effective work team.
Essential Function
Perform onsite and offsite audit of assigned cases comparing the I-bill to the medical record.
-Review findings with hospital representative and obtains an agreement on the discrepancies.
–Updates assigned audits utilizing company provided equipment.
-Good rapport with hospital auditors, medicals records department and business office staff.
-Identifies any hospital related issues and recommends possible solution. Will resolve when appropriate.
-Acts as liaison and troubleshooter between providers and Carewise Health.
-Demonstrate tact and understanding in handling problems.
-Meet scheduling deadlines and completes audit reports based on established productivity standards.
-Follows up on audits timely based on established productivity standards.
-Reviews worksheets and totals by category with the bill to ensure a match.
-Re-checks audit mathematical computations before submitting completed audit to office and in accordance with established quality standards.
-Provide support and resource for other nurse auditors.
-Interaction with internal PI leadership and remote MBRPI auditors on regular basis.
-Provide support for workflow management.
-Assist department with special projects as needed.
-Maintains workflow and timelines for all client deliverables
-All other duties as assigned.
Per Diem
Skilled Nursing Services & Residential Care
$78k-97k (estimate)
03/12/2024
06/08/2024
carewisehealth.com
LOUISVILLE, KY
200 - 500
2013
MERLE RYLAND
$10M - $50M
Skilled Nursing Services & Residential Care
Carewise Health uses a combination of the most experienced nurse clinicians to carry out our Clinical Care Management and Payment Integrity services to customers. They are backed up by data and behavioral scientists, engineers and information technologists to ensure they are using the most reliable and valid data and the most advanced technology to support their efforts with customers. Carewise supplements our health care domain, clinical and scientific expertise, with actuarial and financial expertise to ensure our products and services deliver transparent financial results to customers. Care...wise Health has the experience to manage large, complex customers. Carewise Health has one of the largest data repositories and hubs to use in creating unique models and algorithms in support of our products and services. Carewise Health blends clinical and health care data with non-traditional, non-health care data sets to improve predictability and applications of our models.
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